Mastitis ruining my BF relationship

I have struggled with a cracked nipple that just doesn't want to heal ever since LO was about 2 months. He's 11.5 months now (bday next week!) and so far I've made it BFing. However, this stubborn crack refuses to heal, and every now and then I get mastitis, primary cause = staph, obviously entering through the crack. I apply APNO on the nipple after every feed, wear clean breast pasts to protect it, and am super careful about washing my hands before touching the breast. Needless to say, I'm exhausted. I feel dealing with this is a major hindrance to just enjoying BFing--I have to wear a bra 24/7 to protect the nipple, apply the APNO all day, wash/sanitize constantly, can't wear some of my shirts b/c the breast pad shows through, wash breast pads (which I don't need otherwise b/c I never leak) constantly. I just want to be a "normal" BF mom who can lift a shirt, latch baby, then go about her business, especially at night when I'm tired.

My original goal at the beginning was to make it to a year. DS had a tongue-tie that was corrected at 9 days old, but damage was lasting. Nipple crack on R breast healed within 2 months, but new crack developed on L nipple and did not go away like it did in the R, despite the fact that I treated both the same. I've seen an IBCLC nurse, 2 dermatologists, my ob, and local LLL leader, but nothing seems to have helped.

I would like to continue BFing for as long as DS wants, but dealing with this is making me want to wean sooner rather than later. Right now, he nurses before his morning and afternoon naps, down for bedtime, and then twice overnight. I also pump as soon as I wake (about 3 oz) so I have milk to give him with his meals since he is not yet ready for cow's milk. I would like to gradually wean, as nursing is the best way to get him to sleep and it comforts him. I don't want to take this away from him until HE is ready. I would also like to feel enjoyment over the whole experience, but the constant worrying about the crack, its treatment, and occasional mastitis coupled with having to take antibiotics is ruining the experience for me.

Yesterday my OB said that for some women the crack will not go away until they are done with nursing, since the nipple is constantly experiencing "trauma." She indicated that it may not happen for a 2nd baby, and I really hope that is true b/c I would hate to do this all over again. But I would, b/c I know BM is the best for babies!

I'm really frustrated. I don't know if I'm just looking for some sympathy right now or some advice...

Re: Mastitis ruining my BF relationship

I wonder if the long term use of the APNO is hindering you. Steroids can thin the skin with long-term use, so I wonder if you'd have better luck using a plain antibiotic ointment, rather than the APNO?

I could, of course, be totally off the mark. But it might be worth a try!

Re: Mastitis ruining my BF relationship

Originally Posted by @llli*carm3

I wonder if the long term use of the APNO is hindering you. Steroids can thin the skin with long-term use, so I wonder if you'd have better luck using a plain antibiotic ointment, rather than the APNO?

I could, of course, be totally off the mark. But it might be worth a try!

That's a really good thought.

Has anyone cultured the wound? In cases like this, I have to wonder if there's some resistant strain of bacteria living in there that is just laughing off every single round of antibiotics...

Re: Mastitis ruining my BF relationship

As to the APNO, yes, I've tried some polysporin, and the nipple gets really sore and more red. APNO seems to help, and the crack will almost heal--it healed around April and I was "free" for about 3-4 weeks until one bad latch (at night when I couldn't see) caused some friction blisters that eventually popped and the crack came back . My OB did give me a strong steroid cream that a dermatologist she works with recommended, and that seemed to help when I applied it once a day (used in March/April and crack did heal).

As to the antibiotics--I've only had mastitis in this breast 2x (because I'm so diligent about washing, sanitizing, protecting crack, and applying APNO). Both time the wound was cultured and it was staph. So I'm taking clindamycin to clear it up, which is one of the few antibiotics that will work on staph. The mastitis will go away, but looms over my head with this stupid crack that won't heal. So if I don't take care of the crack every single feed, I risk getting another infection.

Re: Mastitis ruining my BF relationship

It's really interesting that the crack worsened when you quit the APNO and just used the polysporin. APNO contains an antibiotic, a steriod, and an antifungal, right? So what if the issue here is fungal (most likely thrush) and the APNO keeps it in check, but isn't enough to make it heal?

Re: Mastitis ruining my BF relationship

I thought about that. I don't have any other symptoms of thrush--no redness, no itching, no white spots in LO's mouth, no stabbing pain (or any pain, for that matter, crack doesn't cause any discomfort), no problems with the other nipple. Since I'm on 7 days of strong antibiotics, I had my OB also give me fluconazole to take daily, 200 mg, as a precaution to getting vaginal/breast yeast. So if there is any kind of yeast, that plus the APNO should take care of it, right? She gave me enough meds for 14 days, which is standard LC treatment for thrush, but said that I should probably only take it for 7 days while on antibiotics since it's a precaution to prevent yeast, not to cure existing infection. She said that I could keep the remaining pills in case I feel like I'm getting yeast in the future.

Re: Mastitis ruining my BF relationship

A friend used LilyPadz, she told me she had cracks all the time and that these pads helped her nipples to heal from the inside out... they decrease the milk supply a bit but she said she went back to normal after a couple of days and her nipples healed much faster... I wish you good luck and wish things get better!

Re: Mastitis ruining my BF relationship

Aw, sorry you're so overwhelmed by the routine you have to go through! I would be, too.

I'm not so up on the medical issues; it sounds like you've got some good thoughts from the above posts. But I just wanted to encourage you that there's no reason to wean because of ONE breast causing problems. I've been feeding my second baby on just one breast (she simply didn't like the other one, and because of it having essentially no nipple, it is VERY prone to mastitis) since 3 months old, and she will turn 1 next month. So I just wanted to remind you that even if you decide that one breast is too much trouble, you could still wean baby off the one breast and onto just the other gradually. That's what I did, and it just recently stopped leaking much so I am just producing all her milk from my left breast. And I am very small-breasted; size has nothing to do with it and it's totally possible!

Re: Mastitis ruining my BF relationship

But I just wanted to encourage you that there's no reason to wean because of ONE breast causing problems. I've been feeding my second baby on just one breast (she simply didn't like the other one, and because of it having essentially no nipple, it is VERY prone to mastitis) since 3 months old, and she will turn 1 next month. So I just wanted to remind you that even if you decide that one breast is too much trouble, you could still wean baby off the one breast and onto just the other gradually. That's what I did, and it just recently stopped leaking much so I am just producing all her milk from my left breast. And I am very small-breasted; size has nothing to do with it and it's totally possible!

That's an interesting thought, and I had considered it. Now that he will be getting more calories from solids, I could still nurse him on one breast. It's just too bad because the left breast, the cracked one, is my "super boob" that produces a lot, while the right has less. I'm not sure about how to go about weaning from the left--it has mastitis now, so of course I need to nurse from that side now. Also, when I do nurse him, he falls asleep at the breast, and I move him to the other side, cradle position, and he wakes enough to latch, then drinks more. I suppose he won't need the calories from a second breast much longer. But how to "dry up" one breast and keep the other producing? I fear that the left will become engorged and at risk for more mastitis.

Re: Mastitis ruining my BF relationship

I know ... it's tricky, but honestly all I did was just gradually used my left breast more and my right breast less, until finally one day we didn't use it at all - and it did leak for months and months, but just a bit when she would nurse, and now it seems to have gotten the message completely. I did have mastitis in it a month ago, long after we stopped nursing on it. And I wasn't quite sure what to do because of course I couldn't get her to nurse on it - the usual advice for blocked ducts! But I just massaged it out in the tub as best I could and let the fever do its work. Keeping an eye on it of course, because I have wound up in the ER getting IV antibiotics and fluids with mastitis before, and I will never let it get to that point again if I can help it!!

Hope that helps? Let me know if you have any other specific questions about it!